Human cytomegalovirus neutralizing antibody response in Japanese children with bone marrow transplantation

Relationship between human cytomegalovirus glycoprotein B genotype and serum alanine aminotransferase elevation in infants

The glycoprotein B (gB) region of the human cytomegalovirus (HCMV) is a major envelope glycoprotein that is a principal target of neutralizing antibodies and is known to stimulate the immune response of cytotoxic T lymphocytes. HCMV is currently classified into four genotypes on the basis of the nucleotide sequence of the gB region. The presence of HCMV in patients under 3 years of age was determined by subjecting urine samples taken from the patients to polymerase chain reaction (PCR) analysis. Analysis by direct sequencing of the gB region was carried out in 90 cases. These cases were grouped into the gB genotype 1 and gB genotype 3. Of 28 cases with a peak serum alanine aminotransferase (ALT) level(> or =100 IU/l), the duration of observed serum ALT elevation in the gB genotype 1 patients (166.7+/-126.7 days [mean+/-S.D.] [19 cases]) was significantly longer than that in the gB genotype 3 patients (39.7+/-31.7 days [9 cases]) (p<0.01). In the 54 cases with a serum ALT level(> or =50 IU/l), similar tendency was seen (p<0.05). These findings suggest that when serum ALT elevation is confirmed in young children infected with HCMV, analysis of the gB region is helpful for prediction of the duration of serum ALT elevation in the early stage of infection.

PCR-RFLP analysis of cytomegalovirus infections associated with bone marrow transplantation in Japanese children

In order to investigate the longitudinal molecular epidemiology of cytomegalovirus (CMV) infections associated with bone marrow transplantation (BMT) in Japanese children, we analyzed 36 CMV strains from 11 cases. Three regions (DNA polymerase, glycoprotein H, and immediate-early regions) of CMV DNA were amplified by polymerase chain reaction (PCR), and amplified products were each digested with two restriction enzymes, followed by electrophoresis. These restriction fragment length polymorphism (RFLP) analyses allowed the differentiation of 36 strains into 13 genotypes. Each patient excreted his or her own CMV with distinct genotype over the study period of up to one year. CMVs of two different genotypes were recovered during a one-month study from one recipient, who received a peripheral blood stem cell transplantation. Although the majority of patients and donors were CMV-seropositive before BMT, multiple CMV infections might not be common and the reactivation of latently infected CMV might be prominent in Japanese children receiving transplants.